Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Ave, Boston, MA 02118, USA.
School of Nursing and Department of Community Health Systems at the University of California, San Francisco, CA 94143, USA.
J Subst Use Addict Treat. 2024 Feb;157:209190. doi: 10.1016/j.josat.2023.209190. Epub 2023 Oct 20.
Significant disparities in substance use severity and treatment persist among women who use drugs compared to men. Thus, we explored how identifying as a woman was related to drug use and treatment experiences.
The study recruited participants for a qualitative interview study in Boston and San Francisco from January-November 2020. Self-identified women, age ≥ 18 years, with nonprescribed opioid use in the past 14 days were eligible for inclusion. The study team developed deductive codes based on intersectionality theory and inductive codes generated from transcript review, and identified themes using grounded content analysis.
The study enrolled thirty-six participants. The median age was 46; 58 % were White, 16 % were Black, 14 % were Hispanic, and 39 % were unstably housed. Other drug use was common with 81 % reporting benzodiazepine, 50 % cocaine, and 31 % meth/amphetamine use respectively. We found that gender (i.e., identifying as a woman) intersected with drug use and sex work practices and exacerbated experiences of marginalization. Violence was ubiquitous in drug use environments. Some women reported experiences of gender-based violence in substance use service settings that perpetuated cycles of trauma and reinforced barriers to care. Substance use services that were women-led, safe, and responsive to women's needs were valued and sought after.
Women reported a cycle of trauma and drug use exacerbated by oppression in substance use services settings. In addition to increasing access to gender-responsive care, our study highlights the need for greater research and examination of practices within substance use service settings that may be contributing to gender-based violence.
与男性相比，女性吸毒者在药物使用严重程度和治疗方面存在显著差异。因此，我们探讨了将自己定义为女性与药物使用和治疗经历之间的关系。
本研究于 2020 年 1 月至 11 月在波士顿和旧金山招募了符合条件的参与者参加定性访谈研究。自我认同为女性，年龄≥18 岁，过去 14 天内有非处方阿片类药物使用史的人有资格参加。研究团队基于交叉性理论制定了演绎性编码，并从转录本审查中生成了归纳性编码，并使用扎根内容分析确定了主题。
本研究共纳入 36 名参与者。参与者的中位数年龄为 46 岁；58%为白人，16%为黑人，14%为西班牙裔，39%为无稳定住房者。其他药物使用也很常见，分别有 81%、50%和 31%的参与者报告分别使用苯二氮䓬类药物、可卡因和冰毒/安非他命。我们发现，性别（即，自我认同为女性）与药物使用和性工作实践相互作用，加剧了边缘化的体验。在药物使用环境中，暴力无处不在。一些女性报告说在药物使用服务环境中经历了基于性别的暴力，这延续了创伤循环，并强化了获得护理的障碍。女性领导、安全并能回应女性需求的药物使用服务受到重视和追捧。
女性报告说，在药物使用服务环境中受到压迫，经历了创伤和药物使用的恶性循环。除了增加获得性别响应性护理的机会外，我们的研究还强调了需要进一步研究和检查药物使用服务环境中的实践，这些实践可能是导致基于性别的暴力的原因。
